Case Series
Volume 21 Issue 8 - 2022
Correction of a Class II Skeletal Open Bite: The Teuscher Activator, Part 1
Giulia Savastano*
International College of Neuromuscular Orthodontics and Gnathology (ICNOG), Italy
*Corresponding Author: Giulia Savastano, International College of Neuromuscular Orthodontics and Gnathology (ICNOG), Italy.
Received: June 17, 2022; Published: July 28, 2022


Introduction: The signs and symptoms of Temporo-Mandibular-Joint (TMJ) dysfunction may accompany cases of class II open bite more frequently than the general population. As this skeletal morphology can increase in risk factors that can compromise TMJ function, orthodontic correction should be carried out with particular care. Mandibular tracking and surface electromyography (sEMG) are important for diagnostics and follow-up.

Aim: To apply the principals of neuromuscular dentistry to orthodontics in class II skeletal open-bite patients.

Methods: This study’s diagnostic and follow-up procedure is based on the use of mandibular tracking (MKG: mandibular kinesiography, or CMS: craniomandibular scanning), surface electromyography (sEMG), and transcutaneous electrical serve stimulation (TENS), according to neuromuscular dentistry principles.

Results: Overjet was reduced, and TMJ signs and symptoms were resolved. Overjet and dental open bite were corrected. The occlusal plane rotated anticlockwise.


Keywords: Neuromuscular Orthodontics; Transcutaneous Electrical Nerve Stimulator; Mandibular Posture; Mandibular Kinesiography; Surface Electromyography


  1. Tanimoto K., et al. “Characteristics of the Maxillofacial Morphology in Patients with Idiopathic Mandibular Condylar Resorption”. Journal of Clinical Medicine4 (2022).
  2. Tanne K., et al. “Association between malocclusion and temporomandibular disorders in orthodontic patients before treatment”. Journal of Orofacial Pain2 (1993): 156-162.
  3. Riolo ML., et al. “Associations between occlusal characteristics and signs and symptoms of TMJ dysfunction in children and young adults”. American Journal of Orthodontics and Dentofacial Orthopedics6 (1987): 467-477.
  4. Yan ZB., et al. “Craniofacial Morphology of Orthodontic Patients with and without Temporomandibular Disorders: A Cross-Sectional Study”. Pain Research and Management (2022): 9344028.
  5. Sonnesen L and I Kjaer. “Cervical column morphology in patients with skeletal open bite”. Orthodontics and Craniofacial Research1 (2008): 17-23.
  6. Sonnesen L., et al. “Malocclusion traits and symptoms and signs of temporomandibular disorders in children with severe malocclusion”. European Journal of Orthodontics5 (1998): 543-559.
  7. Kuroda S., et al. “Anterior open bite with temporomandibular disorder treated with titanium screw anchorage: evaluation of morphological and functional improvement”. American Journal of Orthodontics and Dentofacial Orthopedics4 (2007): 550-560.
  8. Byun ES., et al. “Relationship between internal derangement of the temporomandibular joint and dentofacial morphology in women with anterior open bite”. American Journal of Orthodontics and Dentofacial Orthopedics1 (2005): 87-95.
  9. 'Applying neuromuscular techniques in the orthodontic setting”. South European Journal of Orthodontics and Dentofacial Research 4 (2017): 31-42.
  10. Savastano F. “Correction of a Class II Occlusion in an Adult”. Journal of Dental Health, Oral Disorders and Therapy2 (2014).
  11. Savastano FJBD. “Contemporary Dental Occlusion in Orthodontics”. BAOJ Dentistry001 (2015): 4.
  12. Neuromuscular dental diagnosis and treatment: Robert R. Jankelson Ishiyaku Euro America, St. Louis: 1990. 687 pages, 1132 illustrations. American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 99.3 (1991): 283-284.
  13. Jankelson B. “Measurement accuracy of the mandibular kinesiograph--a computerized study”. Journal of Prosthetic Dentistry6 (1980): 656-666.
  14. Jankelson B and JC Radke. “The myo-monitor: its use and abuse (I)”. Quintessence International2 (1978): 47-52.
  15. Jankelson B and CW Swain. “Physiological aspects of masticatory muscle stimulation: the myomonitor”. Quintessence International12 (1972): 57-62.
  16. Sandikçioğlu M., et al. “Atlas morphology in relation to craniofacial morphology and head posture”. European Journal of Orthodontics2 (1994): 96-103.
  17. Solow B and A Tallgren. “[Head position and craniofacial morphology]”. Mondo Ortodontico6 (1977): 75-99.
  18. Teuscher U. “A growth-related concept for skeletal class II treatment”. American Journal of Orthodontics3 (1978): 258-275.
  19. Fushima K., et al. “Significance of the cant of the posterior occlusal plane in class II division 1 malocclusions”. European Journal of Orthodontics1 (1996): 27-40.
  20. Tanaka EM and S Sato. “Longitudinal alteration of the occlusal plane and development of different dentoskeletal frames during growth”. American Journal of Orthodontics and Dentofacial Orthopedics5 (2008): 602.
Flynn W., et al. “Delivering online alternatives to the anatomy laboratory: Early experience during the COVID‐19 pandemic” (2021).
  • Ferri F., et al. “Online Learning and Emergency Remote Teaching: Opportunities and Challenges in Emergency Situations” (2020).
  • Citation: Giulia Savastano. “Correction of a Class II Skeletal Open Bite: The Teuscher Activator, Part 1”. EC Dental Science 21.8 (2022): 43-56.

    PubMed Indexed Article

    EC Pharmacology and Toxicology
    LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

    PMID: 31143884 [PubMed]

    PMCID: PMC6536005

    EC Pharmacology and Toxicology
    Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

    PMID: 31565701 [PubMed]

    PMCID: PMC6764777

    EC Neurology
    Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

    PMID: 27747317 [PubMed]

    PMCID: PMC5065347

    EC Pharmacology and Toxicology
    Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

    PMID: 31460519 [PubMed]

    PMCID: PMC6711478

    EC Pharmacology and Toxicology
    Is it a Prime Time for AI-powered Virtual Drug Screening?

    PMID: 30215059 [PubMed]

    PMCID: PMC6133253

    EC Psychology and Psychiatry
    Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

    PMID: 30417173 [PubMed]

    PMCID: PMC6226033

    EC Anaesthesia
    Arrest Under Anesthesia - What was the Culprit? A Case Report.

    PMID: 30264037 [PubMed]

    PMCID: PMC6155992

    EC Orthopaedics
    Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

    PMID: 30198026 [PubMed]

    PMCID: PMC6124505

    EC Pulmonology and Respiratory Medicine
    Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

    PMID: 30294723 [PubMed]

    PMCID: PMC6169793

    EC Dental Science
    Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

    PMID: 29285526 [PubMed]

    PMCID: PMC5743211

    EC Microbiology
    Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

    PMID: 29911204 [PubMed]

    PMCID: PMC5999047

    EC Microbiology
    Macrophages and the Viral Dissemination Super Highway

    PMID: 26949751 [PubMed]

    PMCID: PMC4774560

    EC Microbiology
    The Microbiome, Antibiotics, and Health of the Pediatric Population.

    PMID: 27390782 [PubMed]

    PMCID: PMC4933318

    EC Microbiology
    Reactive Oxygen Species in HIV Infection

    PMID: 28580453 [PubMed]

    PMCID: PMC5450819

    EC Microbiology
    A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

    PMID: 26280024 [PubMed]

    PMCID: PMC4533840

    EC Neurology
    Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

    PMID: 28066845 [PubMed]

    PMCID: PMC5214344

    EC Pharmacology and Toxicology
    Paradigm Shift is the Normal State of Pharmacology

    PMID: 28936490 [PubMed]

    PMCID: PMC5604476

    EC Neurology
    Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

    PMID: 28713879 [PubMed]

    PMCID: PMC5510658

    EC Neurology
    Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

    PMID: 28133641 [PubMed]

    PMCID: PMC5267489

    EC Ophthalmology
    OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

    PMID: 29333536 [PubMed]

    PMCID: PMC5766278

    EC Neurology
    Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

    PMID: 31032493 [PubMed]

    PMCID: PMC6483108

    EC Microbiology
    Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

    PMID: 30957099 [PubMed]

    PMCID: PMC6448571

    EC Nutrition
    Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

    PMID: 30101228 [PubMed]

    PMCID: PMC6086333

    EC Ophthalmology
    REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

    PMID: 31080964 [PubMed]

    PMCID: PMC6508883

    EC Gynaecology
    Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

    PMID: 31093608 [PubMed]

    PMCID: PMC6513001

    EC Dental Science
    Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

    PMID: 31552397 [PubMed]

    PMCID: PMC6758937

    EC Microbiology
    Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

    PMID: 31681909 [PubMed]

    PMCID: PMC6824723

    EC Microbiology
    Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

    PMID: 31681910 [PubMed]

    PMCID: PMC6824726

    EC Neurology
    Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

    PMID: 31528859 [PubMed]

    PMCID: PMC6746603

    EC Psychology and Psychiatry
    Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

    PMID: 31276119 [PubMed]

    PMCID: PMC6604646

    EC Anaesthesia
    Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

    PMID: 31406965 [PubMed]

    PMCID: PMC6690616

    EC Pharmacology and Toxicology
    A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

    PMID: 31517314 [PubMed]

    PMCID: PMC6741290

    EC Pharmacology and Toxicology
    Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

    PMID: 31633124 [PubMed]

    PMCID: PMC6800226

    EC Neurology
    Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

    PMID: 29662969 [PubMed]

    PMCID: PMC5898812

    EC Pharmacology and Toxicology
    Hyperbaric Oxygen Therapy for Alzheimer's Disease.

    PMID: 30215058 [PubMed]

    PMCID: PMC6133268

    News and Events

    September Issue Release

    We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the September issue of respective journals and the latest articles can be viewed on the current issue pages.

    Submission Deadline for Upcoming Issue

    ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before October 14, 2022.

    Certificate of Publication

    ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

    Best Article of the Issue

    Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

    Certifying for Review

    ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

    Latest Articles

    The latest articles will be updated immediately on the articles in press page of the respective journals.